What Are Scleral Lenses?

Scleral Lenses: Benefits, Candidacy, and the Fitting Journey

What Are Scleral Lenses?

Scleral lenses are large, rigid contact lenses designed to hold a layer of fluid against the eye surface, promoting comfort and enhancing vision clarity. Understanding their unique design helps explain why they work so well for complex eye conditions.

Scleral lenses are larger than regular contact lenses and are made from a hard, gas-permeable plastic that allows oxygen to reach your cornea. They cover the white area of the eye, known as the sclera, and avoid direct contact with the sensitive cornea. This unique design helps the lens stay stable and centered during blinking, which reduces irritation and increases comfort for many wearers.

The space between the back of the lens and the front of the cornea holds a thin layer of preservative-free saline solution. This fluid reservoir keeps the eye constantly moist and comfortable throughout the day. It also cushions the cornea and creates a perfectly smooth optical surface over any irregularities, which is key to providing clear, sharp vision.

Modern scleral lenses are made from highly oxygen-permeable materials like fluorosilicone acrylates that allow air to reach the cornea, which is essential for maintaining long-term eye health. Common examples include lenses from brands like BostonSight and Onefit MED, which may feature advanced surface treatments like Hydra-PEG coating to enhance comfort. Our ophthalmologists work with laboratories that use the latest technology, including free-form lens design and advanced topography mapping, to create a truly custom fit for each patient.

Benefits of Scleral Lenses

Benefits of Scleral Lenses

Scleral lenses offer unique and significant advantages for patients with certain eye conditions. These lenses can dramatically improve comfort, vision, and overall eye health.

Because scleral lenses rest on the less sensitive white part of the eye instead of the cornea, they greatly reduce rubbing and irritation. Many patients who could not tolerate other types of contact lenses find scleral lenses much more comfortable. The lens design also shields the cornea from dust, debris, and environmental irritants, allowing many patients to wear them for long hours without discomfort.

By creating a perfectly smooth optical surface over an irregular cornea, scleral lenses can correct complex vision distortions. They are especially helpful for conditions like keratoconus or corneal scars. Many patients report sharper, more stable vision with a significant reduction in blurring, glare, and halos around lights.

The fluid reservoir under the lens keeps the cornea constantly bathed in moisture all day long. This continuous hydration can reduce the burning, stinging, and discomfort commonly associated with dry eye syndrome. Patients with moderate to severe dry eyes often find significant relief and may experience a decreased need for frequent use of artificial tears.

Unlike some soft lenses that can shift on the eye, scleral lenses provide a remarkably secure fit. Their large diameter and custom design help the lens resist shifting or falling out, even during sports and other active movements. This stability ensures clear and consistent vision throughout the day for a wide range of activities.

Who Is a Candidate for Scleral Lenses?

Who Is a Candidate for Scleral Lenses?

A variety of eye conditions can make someone an excellent candidate for scleral lenses. Many patients who have struggled with glasses or other types of contact lenses find success with this advanced option. Our ophthalmologists at ReFocus Eye Health Hatboro have extensive experience fitting patients with complex vision needs.

Keratoconus is a condition that causes the cornea to bulge into a cone shape, leading to distorted and blurry vision. Scleral lenses vault over this irregular surface, creating a smooth optical window that provides clear vision not possible with glasses or soft lenses. Their rigid design can also correct high levels of nearsightedness and astigmatism simultaneously.

For patients with chronic dry eye conditions, including Sjögren's syndrome or graft-versus-host disease, scleral lenses can be life-changing. The lens reservoir holds saline solution against the cornea, protecting it and keeping it hydrated. This moisture barrier often reduces the need for eye drops and provides lasting relief from painful symptoms.

After procedures like corneal transplants or complicated LASIK, the cornea may have scars or an irregular shape that affects vision. Scleral lenses can correct vision by covering these uneven areas with a smooth surface. They also protect the healing cornea from eyelid friction and environmental factors, making them a safe and effective choice during recovery.

Patients with high or irregular astigmatism often find that soft lenses do not fully correct their vision or tend to rotate, causing vision to fluctuate. The rigid design of scleral lenses addresses large amounts of astigmatism effectively. Because the lens remains stable on the eye, the vision stays consistently clear.

The Fitting Journey for Scleral Lenses

Getting fitted for scleral lenses is a personalized, multi-step process that requires expertise and precision. Each step is designed to ensure your lenses fit comfortably, provide clear vision, and maintain your eye health.

During your first visit with our ophthalmologists, a comprehensive eye health exam will be performed, including a review of your medical history and discussion of your lifestyle needs. They will measure your cornea's shape and test your vision. The exam also includes assessing your tear quality and eyelid position to determine if scleral lenses are the right option for you.

Next, our ophthalmologists will place different trial lenses on your eyes to evaluate the fit, comfort, and vision. You may try several lens sizes and curves to find the best match. This trial allows the doctor to assess how the lens interacts with your eye and tear reservoir, and it provides crucial information for designing your final custom lenses.

ReFocus Eye Health Hatboro uses advanced diagnostic tools like corneal topographers and scleral profilometry to map the unique surface of your eye in great detail. These precise measurements ensure that the lens vaults over your cornea correctly without touching it. Accurate mapping is essential for creating a perfect fit and reduces the need for multiple adjustments later on.

Using the data from your eye exam and diagnostic trial, the laboratory crafts a bespoke scleral lens tailored to your eye's specific curvature, size, and vision needs. Manufacturing your custom lenses typically takes one to three weeks. You will receive a pair of lenses designed specifically for your eyes.

Once your custom lenses arrive, you will return for a follow-up visit to check the fit, vision, and comfort. Our ophthalmologists will examine how the lens sits on your eye and may make minor tweaks to the design to optimize the fit. This visit ensures the lenses do not cause redness or excessive pressure, so they feel comfortable and provide clear vision all day.

Learning how to handle your scleral lenses is an important final step. Our doctors and staff will provide hands-on training, showing you how to fill the lens with saline, place it on your eye, and remove it safely. You will also learn the correct procedures for cleaning and storing your lenses to keep your eyes healthy. With practice, lens care becomes a quick and easy part of your daily routine.

Frequently Asked Questions

Frequently Asked Questions

Here are answers to some of the most frequently asked questions patients have about scleral lenses.

Yes, many patients find scleral lenses more comfortable than traditional rigid or soft lenses because they rest on the white part of the eye and cushion the cornea with a layer of fluid. It may take a few days to adjust, but most people adapt quickly. If you experience any discomfort, our ophthalmologists can make small adjustments to improve the fit.

Most patients can comfortably wear scleral lenses for 10 to 14 hours a day. Your specific wear time will depend on your individual comfort and eye health. It is important to remove your lenses before sleeping unless your eye doctor specifically advises otherwise for therapeutic reasons.

Proper cleaning is crucial for eye health. You should clean your lenses daily using either a multipurpose solution or a hydrogen peroxide-based system recommended by your eye doctor. Always rub and rinse the lenses before storing them overnight in a clean case with fresh disinfecting solution. Never use tap water or homemade saline, as they can cause serious eye infections.

Yes, scleral lenses are highly beneficial for dry eye sufferers. Their design creates a fluid-filled reservoir that continuously hydrates the cornea, reducing dryness, irritation, and light sensitivity. They also shield the eye from wind and allergens, providing significant comfort for those with moderate to severe dry eye.

After your initial fitting, a follow-up is typically scheduled within one to two weeks to assess lens performance. Once the fit is finalized, regular check-ups every six months are recommended to monitor your eye health and the condition of the lenses. More frequent visits may be needed if any issues arise.

Absolutely. Many first-time contact lens wearers adapt well to scleral lenses due to their stability and comfort. Our team provides comprehensive training on insertion, removal, and care to ensure new users feel confident and safe wearing their lenses.

Yes, scleral lenses can be an excellent option for children and teenagers with specific conditions like keratoconus, severe dry eyes, or high refractive errors. A specialist will carefully evaluate the young patient's needs and ensure they can safely handle and care for the lenses.

Scleral lenses often improve night vision by providing a smooth optical surface that reduces glare, halos, and starbursts caused by irregular corneas. While results vary, many patients report a significant improvement in their ability to see clearly at night.

Scleral lenses are designed for a secure fit and rarely fall out. If a lens does become dislodged, gently rinse it with sterile saline solution and carefully reinsert it. If this happens frequently, it could indicate an improper fit, and you should schedule an appointment with your eye doctor for an evaluation.

Scleral lenses are very stable and are great for most sports. However, they should never be worn while swimming or in hot tubs due to the high risk of severe eye infections from waterborne microorganisms. If you must wear them near water, waterproof goggles are required for protection.

Scleral lenses are made from durable, rigid materials designed to withstand daily wear. With proper handling and care, they typically last for one to two years before requiring replacement. Their lifespan depends on your usage, maintenance routine, and changes in your eyes over time.

Yes, scleral lenses are medical devices that must be prescribed and custom-fitted by a qualified eye care professional. The detailed fitting process ensures the lenses provide optimal vision correction, comfort, and safety for your eyes.

Yes, but you should take some precautions. Always insert your lenses before applying makeup and remove your lenses before washing your face or removing makeup. It is best to use non-oily, water-based products and avoid applying eyeliner to the inner eyelid margin to prevent contamination and irritation.

While generally safe, all contact lenses carry some risks, including infection, irritation, or inflammation. These risks are minimized by following proper cleaning procedures and attending regular follow-up appointments. If you experience redness, pain, or changes in your vision, remove the lenses immediately and contact your eye doctor.

Scleral lenses offer superior vision correction and comfort for patients with irregular corneas, severe dry eye, or other complex eye conditions. Soft lenses may be more suitable for individuals with healthy corneas and mild to moderate vision correction needs. Your eye doctor will recommend the best lens type for you based on your unique eye health and visual goals.

Your Vision, Our Expertise

Your Vision, Our Expertise

Scleral lenses can be a truly remarkable solution for those who struggle with keratoconus, dry eyes, corneal irregularities, or post-surgical vision problems. At ReFocus Eye Health Hatboro, our ophthalmologists have the expertise, advanced technology, and personalized approach to guide you through every step of the fitting journey. Whether you are in Hatboro, Warminster, Southampton, Abington, or elsewhere in the Greater Philadelphia region, we are here to help you achieve the clear, comfortable vision you deserve. Contact us today to schedule your consultation and discover whether scleral lenses are the right choice for your eye care needs.

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